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Vascular ring in an extremely low birth weight infant
Tomomi Hasegawa1, Masahiro Yamaguchi, Naoki Yoshimura
1Department of Cardiothoracic Surgery, Kobe Children's Hospital, Kobe, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|January 14, 2004
Summary
This case report details a rare vascular ring in an extremely low birth weight (ELBW) infant, diagnosed late due to prolonged intubation. Early suspicion of tracheal compression is crucial for ELBW infants with difficult extubation.
Area of Science:
- Pediatric Surgery
- Cardiology
- Neonatology
Background:
- Vascular rings, arising from aortic arch anomalies, commonly cause tracheoesophageal obstruction in infants.
- Diagnosis of vascular rings in extremely low birth weight (ELBW) infants is exceptionally rare, with no prior reports.
- Prolonged tracheal intubation can mask the symptoms of vascular rings in ELBW infants.
Observation:
- A case of a 560g ELBW infant is presented, diagnosed with a vascular ring at 6 months of age.
- The infant experienced asymptomatic presentation due to prolonged tracheal intubation.
- The patient had a double aortic arch with tracheomalacia.
Findings:
- Surgical intervention included division of the atretic left arch and ligamentum arteriosus, aortopexy, and tracheostomy.
- The infant achieved full recovery by 3 years of age.
- This case highlights the successful surgical management of a vascular ring in an ELBW infant.
Implications:
- Difficulty in extubation in ELBW infants, even with improved respiratory status, warrants suspicion of tracheal compression.
- Vascular rings should be considered in the differential diagnosis for persistent respiratory issues in ELBW infants.
- This report expands the understanding of vascular ring presentation and management in extremely premature neonates.